DNA damage and molecular level effects induced by polystyrene (PS) nanoplastics (NPs) after Chironomus riparius (Diptera) larvae.

In this work, we analyzed the early molecular effects of polystyrene (PS) nanoplastics (NPs) on an aquatic primary consumer (larvae of Chironomus riparius, Diptera) to evaluate their potential DNA damage and the transcriptional response of different genes related to cellular and oxidative stress, endocrine response, developmental, oxygen transport, and immune response. After 24-h exposures of larvae to doses of PS NPs close to those currently found in the environment, the results revealed a large genotoxic effect. This end was evidenced after significant increases in DNA strand breaks of C. riparius larvae quantified by the comet assay, together with results obtained when analyzing the expression of four genes involved in DNA repair (xrrc1, ATM, DECAY and NLK) and which were reduced in the presence of these nanomaterials. Consequently, this reduction trend is likely to prevent the repair of DNA damage caused by PS NPs. In addition, the same tendency to reduce the expression of genes involved in cellular stress, oxidative stress, ecdysone pathway, development, and oxygen transport was observed. Taken together, these results suggest that PS NPs reduce the expression of hormonal target genes and a developmental gene. We show, for the first time, effects of PS NPs on the endocrine system of C. riparius and suggest a possible mechanism of blocking ecdysteroid hormones in insects. Moreover, the NPs were able to inhibit the expression of hemoglobin (Hb C), a protein involved in oxygen transport, and activate a gene of the humoral immune system. These data reveal for the first time the genomic effects of PS NPs in the aquatic invertebrate C. riparius, at the base of the food chain.

Ossifying Fibromyxoid tumor of soft parts in head and neck: case report and literature review.

BACKGROUND: Ossifying fibromyxoid tumor of soft parts (OFMT), is a rare but morphologically distinctive neoplasm of uncertain histogenesis that most frequently affects middle-aged male adults. Clinically, it usually presents as a slowly enlarging, small, circumscribed mass, which in most cases is painless. OFMT is most frequently found within the subcutaneous tissues of extremities or trunk, and rarely in the oral/head and neck region. We present an unusual case of this tumor in the submandibular region, and, based on the current medical literatures this is probably the first case described in this anatomical location. CASE PRESENTATION: A 32-year-old male presented to our outpatient clinic with a right submandibular mass with 1-year of evolution. Excisional biopsy showed that it was characterized by ossification along the periphery of the lesion. The neoplastic cells were spindle-like with scant eosinophilic cytoplasm. These cells were arranged with uniform cell-to-cell space in a fibromyxoid stroma. Small and large clusters of calcifications were present within the tumor. Immunohistochemically, the case showed positive staining of S-100 protein, vimentin, nestin, calponin, SMA, GFAF, desmin, INI-1, caldesmon, and CD34. It also showed negative staining of CK, CK7, CK8/18, NF, and EMA. About 2% of neoplastic cells showed positive staining of Ki67. Based on these features, the final pathological diagnosis was OFMT. CONCLUSIONS: It is hoped that a greater understanding of OFMT in the head and neck region will avoid potential misdiagnosis, and contribute to determining the correct management, which appears to be complete surgical excision with close follow-up for recurrence surveillance.

Low-cost Method for Obtaining Medical Rapid Prototyping Using Desktop 3D printing: A Novel Technique for Mandibular Reconstruction Planning.

BACKGROUND: Three-dimensional (3D) printing is relatively a new technology with clinical applications, which enable us to create rapid accurate prototype of the selected anatomic region, making it possible to plan complex surgery and pre-bend hardware for individual surgical cases. This study aimed to express our experience with the use of medical rapid prototype (MRP) of the maxillofacial region created by desktop 3D printer and its application in maxillofacial reconstructive surgeries. MATERIAL AND METHODS: Three patients with benign mandible tumors were included in this study after obtaining informed consent. All patient's maxillofacial CT scan data was processed by segmentation and isolation software and mandible MRP was printed using our desktop 3D printer. These models were used for preoperative surgical planning and prebending of the reconstruction plate. CONCLUSIONS: MRP created by desktop 3D printer is a cost-efficient, quick and easily produced appliance for the planning of reconstructive surgery. It can contribute in patient orientation and helping them in a better understanding of their condition and proposed surgical treatment. It helps surgeons for pre-operative planning in the resection or reconstruction cases and represent an excellent tool in academic setting for residents training. The pre-bended reconstruction plate based on MRP, resulted in decreased surgery time, cost and anesthesia risks on the patients. Key words:3D printing, medical modeling, rapid prototype, mandibular reconstruction, ameloblastoma.

Dolor abdominal en puerperio. Perforación uterina y formación de pseudoquiste peritoneal / Abdominal pain in the puerperium. Uterine perforation and peritoneal pseudocyst formation

Debido al número creciente de la tasa de cesáreas, el riesgo de rotura uterina probablemente aumentará. La mayoría aparecen intraparto, siendo más raro un diagnóstico durante el postparto. Se presenta el caso de una mujer de 35 años de edad con antecedente de cesárea anterior hace 4 años que acude a urgencias con un cuadro de dolor abdominal y empeoramiento del estado general, tras parto instrumental 2 semanas antes (AU)

Due to increasing rate of cesarean deliveries, the risk of uterine rupture would probably rise. Most of them appear during labour, being less common a postpartum period diagnosis. Our case report describes a 35-year-old woman with previous caesarean section 4 years ago, who goes to emergency services with abdominal pain and poor performance status after having an instrumental delivery 2 weeks before (AU)

Manejo quirúrgico de tumor mandibular asistido con la tecnología de impresión tridimensional: nota técnica y reporte de caso / Surgical management of mandible tumor assisted with three-dimensional printing technology: a technical note and case report

Objetivo: Introducir la tecnología de impresión tridimensional para la creación de modelos anatómicos para asistir la planificación quirúrgica de tumores mandibulares. Caso clínico: Presentamos el caso de una paciente de 30 años con historial de tumoración en la mandíbula, sector anterior, con 2 años de evolución. La biopsia incisional confirmó que se trataba de un fibroma osificante. Con la asistencia de la tecnología de impresión tridimensional se realizó la planificación quirúrgica para establecer los márgenes de osteotomías y el predoblado de la placa de reconstrucción. Adicionalmente se describe en detalle el proceso de construcción del modelo de prototipado rápido con la tecnología de impresión tridimensional.

Aim: Introduction of three-dimensional printing technology for the generation of medical rapid prototyping models, an assistant tool in surgical planning of mandibular tumors. Clinical case: We report the case of a 30-years-old female patient who presented an anterior mandible mass with 2 years of evolution. Incisional biopsy confirmed ossifying fibroma. With the assistance of three-dimensional printing technology, 3D model was created and surgical planning was performed with the design of osteotomy sites for mandibular resection. Furthermore, prebending of reconstruction plate based on 3D model was accomplished. The protocol for rapid prototyping models creation in details is described in this article.

Retrograde submental intubation assisted with direct video laryngoscopy in maxillofacial trauma: technical note and case report / Intubación submentoniana retrógrada asistida con videolaringoscopía en trauma maxilofacial: nota técnica y reporte de caso

The management of a difficult airway is one of the biggest challenges of perioperative anesthesia management. The maxillofacial trauma can cause serious disturbances of the soft and hard tissues of the anatomical components of the upper airway and often with little external evidence of deformity. The submental intubation is a procedure that was reported to avoid tracheostomy and allow for the concomitant restoration of occlusion and reduction of facial fractures in patients with craniomaxillofacial trauma ineligibles for nasotracheal intubation. We described a modification of the original technique by performing a retrograde submental intubation assisted by direct laryngoscope video in a maxillofacial trauma patient with restricted mouth opening. In addition, the surgical anatomy of the technique is detailed described.

El manejo de una vía aérea difícil es uno de los mayores desafíos del manejo anestésico perioperatorio. El trauma maxilofacial puede causar serias alteraciones a los tejidos blandos y duros de la vía aérea superior, y muchas veces con pequeña evidencia externa de deformidad. La intubación submentoniana es un procedimiento que fue reportado para evitar la traqueostomía y permitir la concomitante restauración de la oclusión para la reducción de fracturas faciales en pacientes donde la intubación nasotraqueal está contraindicada. Describimos una modificación de la técnica original, realizando una intubación submentoniana retrógrada asistida con videolaringoscopio en un paciente de trauma maxilofacial con apertura de la cavidad disminuida. Adicionalmente se describe detalladamente la anatomía quirúrgica de la técnica.

Large recurrent radicular cyst in maxillary sinus: a case report / Gran quiste radicular recurrente en seno maxilar: reporte de caso

Radicular cyst is the most common inflammatory jaw cystic lesion that occurs in necrotic teeth. They account for more than 50 % of all odontogenic cysts. Radicular cysts cause slowly progressive painless swelling and there are no symptoms until they become large. Enucleating the cyst with endodontic therapy of the affected tooth is recommended as the primary treatment. Here we describe a patient with a large recurrent radicular cyst with maxillary sinus involvement who underwent a midfacial degloving approach for complete enucleation. In conclusion, radicular cyst should be considered in the differential diagnosis of large maxillary sinus lesions and never be discarded until histopathology is available.

El quiste radicular es la lesión inflamatoria quística más común que ocurre en los dientes necróticos. Su presentación abarca más del 50 % de los quistes odontogénicos. Los quistes radiculares se presentan como una inflamación indolora de crecimiento lento y progresivo y se hacen sintomáticas una vez que alcanzan un gran tamaño. El tratamiento primario recomendado para este quiste es la enucleación junto al tratamiento endodóntico de los dientes afectados. Presentamos un reporte de caso de un paciente que presentaba un gran quiste radicular recurrente con envolvimiento de todo el seno maxilar y que fue tratado con un acceso intraoral extendido para lograr la completa enucleación de la lesión. En conclusión, el quiste radicular debe ser siempre considerado en el diagnóstico diferencial de lesiones de gran tamaño que involucren el seno maxilar y nunca ser descartado hasta tener el resultado de histopatología.

Consideraciones anatómicas en la parotidectomía: revisión de la literatura a propósito de un caso / Anatomical considerations in parotidectomy: review of the literature and case report

La parotidectomía es un procedimiento quirúrgico habitualmente realizado por Cirujanos Maxilofaciales y Cirujanos de Cabeza y Cuello, en el cual se remueve parcialmente o en su totalidad a la glándula parótida. Las indicaciones más comunes para éste procedimiento son las neoplasias de la glándula. Aproximadamente el 80% del total de los tumores de glándulas salivales ocurren en la parótida. De estos, el 75-80% son de naturaleza benigna. Sin embargo, la parotidectomía es un procedimiento sumamente complejo debido a la anatomía regional y por la íntima relación de la glándula parótida con el nervio facial. Siendo la clave de este procedimiento la preservación funcional de éste nervio y de sus ramos. Por lo tanto el conocimiento acabado de la anatomía de la glándula parótida y de sus estructuras anexas es necesario para el éxito quirúrgico. Esta revisión y reporte de caso discutirá las consideraciones anatómicas que deben tenerse durante la parotidectomía para disminuir la posibilidad de alguna complicación.

Parotidectomy is a surgical procedure usually performed by Oral and Maxillofacial Surgeons and Head and Neck Surgeons, in which the parotid gland may be removed partially or totally. The most common indications for this procedure are the neoplasms of the gland. Approximately 80% of total salivary gland tumors occur in the parotid gland. Of these, 75-80% are benign. However, the parotidectomy is a highly complex procedure because of the regional anatomy and the close relationship of the parotid gland with the facial nerve. The most important aspect of this procedure is the functional preservation of the facial nerve and its branches. Therefore, the thorough knowledge of the anatomy of the parotid gland and related structures is necessary for surgical success. This review and case report will discuss the anatomical considerations that must be taken during parotidectomy to reduce the possibility of complications.

Gingival metastasis from a testicular choriocarcinoma: an unusual case report and review of the literature / Metástasis gingival desde un coriocarcinoma testicular: un inusual reporte de caso y revisión de la literatura

Metastasic tumours to the oral cavity are extremely rare lesions that represent 1% of all oral and maxillofacial malignancies. Most reported cases involve the jaw bones than the soft tissues. Metastasis to the oral soft tissues most prevalently affects the gingiva and alveolar mucosa. Gingival metastasis may have an unremarkable clinical appearance and they can be difficult to distinguish from more common hyperplasic or reactive lesions that appear to be benign entities, such as peripheral giant-cell granuloma, pyogenic granuloma and peripheral ossifying fibroma. We present an unusual case of a testicular choriocarcinoma metastasized to the maxillary gingiva mimicking a reactive lesion. In addition, we also present a literature review of previous reported cases and a brief discussion about the etiopathogeny of testicular germ cell tumors, and how these malignant cells can reach the gingival tissues.

Los tumores metastásicos a la cavidad bucal son lesiones extremadamente raras que representan el 1% de todas las neoplasias malignas bucales y maxilofaciales. La mayoría de los casos reportados afectan más a los huesos maxilares que los tejidos blandos. Las metástasis a los tejidos blandos bucales involucran más prevalentemente a la encía y la mucosa alveolar. Las metástasis gingivales pueden tener un aspecto clínico no característico y suelen ser difíciles de distinguir de otras lesiones hiperplásicas o reactivas que parecen ser entidades benignas, tales como el granuloma periférico de células gigantes, el granuloma piogénico y el fibroma osificante periférico. Presentamos un inusual reporte de caso de un coriocarcinoma testicular metastásico a la encía maxilar simulando una lesión reactiva. Además, también se presenta una revisión de la literatura de los casos previamente publicados y una breve discusión acerca de la etiopatogenia de los tumores testiculares de células germinales, y cómo estas células malignas pueden llegar a los tejidos gingivales.

Zinc alpha-2 glycoprotein is implicated in dyslipidaemia in HIV-1-infected patients treated with antiretroviral drugs.

OBJECTIVES: Treated HIV-1-infected patients with lipodystrophy often develop insulin resistance and proatherogenic dyslipidaemia. Zinc alpha-2 glycoprotein (ZAG) is a recently characterized adipokine which has been shown to be involved in the development of obesity and metabolic syndrome in uninfected subjects. We assessed the relationship between circulating ZAG levels and metabolic derangements in HIV-1-infected patients receiving antiretroviral drugs. METHODS: Plasma ZAG levels were assessed in 222 individuals: 166 HIV-1-infected patients treated with antiretroviral drugs (77 with lipodystrophy and 89 without lipodystrophy) and 56 uninfected controls. Plasma ZAG levels were assessed by enzyme-linked immunosorbent assay (ELISA) and were correlated with fat distribution abnormalities and metabolic parameters. RESULTS: HIV-1-infected patients had lower plasma ZAG levels compared with uninfected controls (P < 0.001). No differences were found in ZAG plasma levels according to the presence of lipodystrophy, components of the metabolic syndrome or type of antiretroviral treatment regimen. Circulating ZAG levels were strongly determined by high-density lipoprotein cholesterol (HDLc) in men (B = 0.644; P < 0.001) and showed a positive correlation with total cholesterol (r = 0.312; P < 0.001) and HDLc (r = 0.216; P = 0.005). CONCLUSIONS: HIV-1-infected patients have lower plasma ZAG levels than uninfected controls. In infected patients, plasma ZAG levels are in close relationship with total cholesterol and HDLc.

The unusual evolution of a simple bone cyst in the mandible: A case report.

The simple bone cyst, as newly classified by WHO in 2005, is a lesion related to the jawbones. Therefore, it is not a cyst, since it is a cavity devoid of epithelial tissue. It is a rare pathology affecting the mandible more than the maxilla. Its onset occurs mainly during the first two decades of life, irrespective of sex. The purpose of our report is to exhibit the particular case of a 17-year-old male patient whose radiography showed an osteolytic lesion in his right mandibular body. Exploratory surgery and biopsy are performed showing a simple bone cyst. Since then, he is controlled through imaging studies, but presenting an atypical evolution, with its size increasing considerably within a 4-year follow-up. Key words:Case report, simple bone cyst, hemorrhagic bone cyst, solitary bone cyst, idiophatic bone cyst, mandible.

Anterior and middle superior alveolar nerve block for anesthesia of maxillary teeth using conventional syringe.

BACKGROUND: Dental procedures in the maxilla typically require multiple injections and may inadvertently anesthetize facial structures and affect the smile line. To minimize these inconveniences and reduce the number of total injections, a relatively new injection technique has been proposed for maxillary procedures, the anterior and middle superior alveolar (AMSA) nerve block, which achieves pulpal anesthesia from the central incisor to second premolar through palatal approach with a single injection. The purpose of this article is to provide background information on the anterior and middle superior alveolar nerve block and demonstrate its success rates of pulpal anesthesia using the conventional syringe. MATERIALS AND METHODS: Thirty Caucasian patients (16 men and 14 women) with an average age of 22 years-old, belonging to the School of Dentistry of Los Andes University, were selected. All the patients received an AMSA nerve block on one side of the maxilla using the conventional syringe, 1 ml of lidocaine 2% with epinephrine 1:100.000 was injected to all the patients. RESULTS: The AMSA nerve block obtained a 66% anesthetic success in the second premolar, 40% in the first premolar, 60% in the canine, 23.3% in the lateral incisor, and 16.7% in the central incisor. CONCLUSIONS: Because of the unpredictable anesthetic success of the experimental teeth and variable anesthesia duration, the technique is disadvantageous for clinical application as the first choice, counting with other techniques that have greater efficacy in the maxilla. Although, anesthetizing the teeth without numbing the facial muscles may be useful in restorative dentistry.

Mandibular ameloblastoma in a 10-year-old child: case report and review of the literature / Ameloblastoma mandibular en niño de 10 años: reporte de un caso y revisión de la literatura

The ameloblastoma according to the classification of odontogenic tumors by WHO in 2005, is classified as a benign neoplasm of odontogenic epithelial origin. One to three percent of tumors and cysts of the jaws are comprised of ameloblastomas. The tumor is locally aggressive, but often asymptomatic, showing a slow growth which is manifested as a facial swelling or radiographic incidental finding. On clinical examination, the tumor can cause symptoms such as pain, ulceration, tooth mobility, root resorption and malocclusion. Ameloblastomas have a high rate of recurrence if not completely removed. It occurs in almost all age groups, but is mainly diagnosed in the third or fourth decade of life. The tumor is very rare in children. We present an unusual case of a solid/multicystic ameloblastoma of the mandible in a 10-year-old girl. In addition, a brief review of the literature on reported cases of this pathology in children is also presented...

El ameloblastoma según la clasificación de tumores odontogénicos de la OMS del 2005 lo clasifica como una neoplasia benigna de origen epitelial odontogénico. Compromete el 1-3% de neoplasias y quistes maxilares. El tumor es agresivo localmente, pero muchas veces asintomático; presenta un lento crecimiento que se manifiesta como un aumento de volumen facial o un hallazgo incidental radiográfico. Al examen clínico el tumor puede causar síntomas como dolor, ulceración, reabsorción radicular con movilidad dentaria y maloclusión. El ameloblastoma posee gran tasa de recurrencia si no es totalmente removido. Se presenta en casi todos los grupos etarios pero principalmente se diagnostica en la tercera o cuarta década de vida, el tumor es muy poco común en niños. El tratamiento del ameloblastoma es controversial y debido a la distinta incidencia y comportamiento en niños, hace las consideraciones quirúrgicas diferentes a los adultos. Por lo que presentamos un inusual caso de un ameloblastoma solido/multiquístico mandibular en una niña de 10 años. Además de una breve revisión de la literatura sobre casos reportados de esta patología en niños...

El sistema perceptivo: esa pequeña máquina del tiempo / The perceptual system: That little time-machine

Diversas circunstancias de carácter físico (por ejemplo, el hecho de que la luz y el sonido no viajen a la misma velocidad) y/o fisiológico (la señal auditiva tarda menos que la señal visual en llegar a la corteza cerebral primaria) pueden originar ciertos desajustes temporales entre la información sensorial sobre un mismo evento. Teniendo en cuenta la enorme cantidad de estímulos que nos invade en ciertos momentos, el poder reagrupar las señales sensoriales que pertenecen a un mismo evento, a pesar de la asincronía, puede resultar un mecanismo adaptativo de primer orden. El cerebro humano parece capaz, en definitiva, de hacer reaparecer la simultaneidad allí donde no la hay. ¿Cómo lo logra? Dos fenómenos recientemente descubiertos –la ventriloquia temporal (según la cual, la aparición de un estímulo puede influir en el momento en el que percibimos otros) y la recalibración temporal (a través de la cual, el cerebro realinea las señales asincrónicas que provienen de distintas modalidades sensoriales)– atestiguan que la forma en que lo hace es mucho más activa y flexible de lo que hasta ahora se había imaginado (AU)

Various physical circumstances (for instance, the fact that light and sound do not travel at the same speed) and/or physiological factors (such as the fact that auditory signals are initially processed more rapidly than visual signals) give rise to small asynchronies between sensory signals pertaining to a specific multisensory event. Considering the large amount of sensory stimulation that bombards our senses at any given time, being able to regroup sensory signals that belong to the same event (even if they arrive asynchronously) can be highly adaptative. Indeed, the human brain is by-and-large able to maintain a simultaneous and coherent perception of the proximal events that occur in the environment. How is this achieved? Two recently discovered phenomena –temporal ventriloquism (where the presence of a stimulus in one modality influences the perceived time of occurrence of a stimulus in another modality) and temporal recalibration (where the brain realigns asynchronous signals from different sensory modalities)– confirm that the way in which the human brain maintains synchrony is more active and flexible than previously thought (AU)

Perception of audiovisual speech synchrony for native and non-native language.

To what extent does our prior experience with the correspondence between audiovisual stimuli influence how we subsequently bind them? We addressed this question by testing English and Spanish speakers (having little prior experience of Spanish and English, respectively) on a crossmodal simultaneity judgment (SJ) task with English or Spanish spoken sentences. The results revealed that the visual speech stream had to lead the auditory speech stream by a significantly larger interval in the participants' native language than in the non-native language for simultaneity to be perceived. Critically, the difference in temporal processing between perceiving native vs. non-native language tends to disappear as the amount of experience with the non-native language increases. We propose that this modulation of multisensory temporal processing as a function of prior experience is a consequence of the constraining role that visual information plays in the temporal alignment of audiovisual speech signals.